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General NPI Number Information
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NPI Number | 1699946053
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Entity Type | Organization
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Legal Business Name | BROOKWOOD PSYCHOLOGY LLC
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 3037 MASSEY RD
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City | VESTAVIA
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State | AL
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Zip | 35216-3603
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Country | US
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Telephone | 205-874-9805
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Fax | 205-874-9806
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Provider Business Mailing Address
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Address Line | 3037 MASSEY RD
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City | VESTAVIA
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State | AL
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Zip | 35216-3603
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Country | US
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Telephone | 205-874-9805
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Fax | 205-874-9806
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOEL D MELVIN
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Credential | PHD
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Telephone | 205-874-9805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 799
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License Number State | AL
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